Assessment of the Relationship between Body Mass Index and Incidence of Venous Thromboembolism in Hospitalized Overweight and Obese Patients

作者：Samuel Sophie^*; Gomez Leigh; Savarraj Jude P; Bajgur Suhas; Choi Huimahn A

来源：Pharmacotherapy, 2017, 37(8): 893-899.

DOI：10.1002/phar.1953

• heparin
• risk factors
• venous thromboembolism
• overweight
• obesity

STUDY OBJECTIVE To assess whether a positive linear association exists between body mass index (BMI) and incidence of venous thromboembolism (VTE) in overweight and obese hospitalized patients.
DESIGN Single-center retrospective observational cohort study.
SETTING Large academic tertiary care medical center.
PATIENTS A total of 1452 adults hospitalized between January 1, 2013, and December 31, 2014, who weighed more than 100 kg and had a BMI of 25 kg/m(2) or greater on admission, and received heparin subcutaneously for VTE prophylaxis. Patients were categorized into four subgroups based on World Health Organization BMI classification: overweight (141 patients), obese class I (305 patients), obese class II (324 patients), and obese class III (682 patients).
MEASUREMENTS AND MAIN RESULTS The primary outcome was occurrence of VTE in each subgroup; all-cause mortality and length of hospital stay were secondary outcomes. A linear trend test did not show an association between occurrence of VTE and BMI of 25 kg/m 2 or greater. VTE occurred in 7 (5%) of 141 patients in the overweight group, 5 (2%) of 305 in the obese class I group, 8 (3%) of 324 in the class II group, and 18 (3%) of 682 in the class III group (p= 0.573). In addition, no linear association was noted between all-cause mortality or length of hospital stay and BMI of 25 kg/m 2 or greater. Overall mortality was 10% (146/1452 patients). Ten deaths (7%) occurred in the overweight group, 45 (15%) in the obese class I group, 38 (12%) in the obese class II group, and 53 (8%) in the obese class III group (p= 0.067). The median length of hospital stay was 5 days (interquartile range 3-9, p= 0.122) for all patients.
CONCLUSION In overweight and obese hospitalized patients who weighed more than 100 kg and had a BMI of 25 kg/m(2) or greater, the incidence of VTE did not increase incrementally with increasing severity of obesity.

• 出版日期2017-8